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United Brain Association

Archives for October 2019

Moral Compass

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“One’s philosophy is not best expressed in words; it is expressed in the choices one makes…and the choices we make are ultimately our responsibility.” – Eleanor Roosevelt

Carrying out our caregiving mission is the essence of being true to our moral values.  When we give so selflessly to another, it fulfills our sense of honor, fairness, and goodness…it truly feels like and is the right thing to do.  

Stand proudly in achieving one of the greatest satisfactions in life – caring for another.  In doing so, you are personally growing and giving yourself peace in your heart that lasts long after the caregiving ends.

The Power of Writing for Caregivers

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Have you ever tried writing to help manage the daily stress of being a caregiver? 

Writing is an extremely powerful, creative and cathartic way to vent and express yourself.  Use this tool to put your caregiving experiences into words. Writing captures your feelings in a form that can easily be reviewed later on to gain perspective.  It can help manage difficult situations and allow you to gain insight into your strengths and weaknesses as a caregiver and person.

B. Lynn Goodwin and Margery Pabst, both caregiving journaling experts, recommend that caregivers get in the habit of writing regularly.  Even just short passages, they suggest writing as an outlet with no experience or sentiment too small to reflect on.


Mental Illness: The Harmful Truth Behind Secrets

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Whether it’s feelings of shame, guilt, fear or trying to protect loved ones from the truth, many people with mental illness suffer in silence, choosing not to share their struggles with family and friends.  According to the National Alliance on Mental Illness, over 40 million people in the U.S. – that’s 1 in 5 people – will experience a mental health condition this year.  

Years ago it was common for those suffering from “taboo” disorders such as schizophrenia or depression to be locked in mental institutions or kept in isolation by their families.  While the cultural conversation around mental illness is more widely discussed, many sufferers continue to maintain veils of secrecy out of fear, stigma and the desire to shield others from pain. 

Mental Health America (MHA) released its annual State of Mental Health Report earlier this year and cited that over 76% of youth with severe depression – 1.7 million kids – stayed quiet about their struggles.  Additionally, on average, it takes 10 years between the onset of symptoms and when individuals of all ages receive treatment, reinforcing the idea that many choose to keep their illnesses secret.

Paul Gionfriddo, President and CEO of MHA, said, “Far too many young people are suffering – often in silence. They are not receiving the treatment they need to live healthy and productive lives – and too many simply don’t see a way out.”

More Harm Than Good

Experts agree that keeping secrets is ultimately more harmful and decrease an individual’s overall sense of well-being.

According to Abby Rodman, best-selling author, psychotherapist, coach, and relationship strategist, secrets and lies can wreak havoc on your personal relationships and your health.

“Deciding to keep a secret or tell a lie is always a choice. And, often, we choose either or both because we’re afraid we can’t withstand the consequences of coming clean. But which is preferable: A relationship (and, perhaps, a life) suffocated by the heavy curtains of secrets and lies? Or a deeply-breathed life lived with a clear conscience and self-respect?”

Here’s one man’s personal story about keeping his struggle with mental illness a secret from family and friends:

The Slippery Slope of Secrets

Other harmful effects of keeping secrets include:

  1. Secrets create inauthenticity. Where there are secrets, there may often by lies, and where there are lies, there’s inauthenticity.  The mindset of “what they don’t know, won’t hurt them” is the farthest thing from the truth, and can dramatically shift the dynamic of even the closest of relationships. 
     
  2. Secrets create bad energy.  While attempting to keep information from others, you’re focusing your energy in all the wrong places.  Not being transparent and withholding the truth creates an overarching atmosphere of negativity, even if the other side isn’t aware of it.  
     
  3. Secrets are bad for your health AND your brain. According to Rodman, secrets, especially those that are big and take a lot of energy to keep hidden, can make you sick. She relays that in one study, participants who cut back on lying had fewer mental health and physical complaints and that lying can make people anxious and depressed,  trigger headaches and cause nausea.  “Your brain gets muddled by lying, scientists say. The part of your brain wired to tell the truth is essentially being rewired by your lies, ramping up your stress hormones and interfering with things like learning and memory,” states Rodman.  
     
  4. Secrets make you lonely.  Being vulnerable and honest can be intimidating, and in the case of keeping mental illness a secret, you’re doing yourself an extreme disservice.  Suffering in silence means you’ll be unable to lean on a support system, which can create deep feelings of isolation and make it more difficult to seek appropriate treatment.  
     
  5. Secrets create disrespect. Secrets deprive your loved ones the right to process the impact the information may have on them.  By keeping important things from your loved one, you’re unfairly disrespecting his/her opportunity to make informed decisions or lend support.  
     
  6. Secrets are stressful.  According to Art Markman, Ph.D., Professor of Psychology and Marketing at the University of Texas at Austin said, studies have shown that people find themselves thinking about the secret about three times more often than actively hiding it.  Dr. Markman states, “Keeping secrets may be stressful, but not because of the activity of hiding it from a person. It may be stressful, because you may keep thinking about that information, which reminds you that you have a secret.  Knowing you have a secret may make you feel as though you are not acting authentically, and that can depress your mood.”  

Choose Straight-Forward Communication Over Silence

The video below reinforces how crucial it is to talk openly and not keep secrets when it comes to something as important as your mental health.

Michael Slepian, a professor of management at Columbia Business School, studying the psychological effects of secrecy, the development, and formation of trust, and deception detection say, “The act of confiding a secret can feel cathartic and relieving. But mere catharsis is not enough. When confiding a secret, what is actually helpful is the conversation that follows. People report that when sharing a secret with another person, they often receive emotional support, useful guidance, and helpful advice. These forms of support make people feel more confident and capable of coping with the secret.”

Secrets Have More Power When They Are Kept 

At the American Brain Society, we encourage you to let go of the secrets you’ve been holding on to – your health and well-being depend on it.  Once your support system is aware of any struggles you might be experiencing they can provide sympathy, encouragement and help with concrete action.  

Here are a few tips to help open up the conversation with your loved ones:

  • Decide who to talk to.  It’s your decision to share your struggles with a few close family members or a wider network of people.  If it helps, consider making a pro/con list so that you can see the benefits of telling people who will understand
  • Plan the conversation.  You can get the best support possible by determining what you want to say beforehand.   Try including “process talk” in the conversation, which means “talking about talking,” rather than talking to share information.  For example – “There’s something going on in my life that’s been bothering me for quite some time. I think I need to talk to someone about it. I feel embarrassed and sometimes confused, so please try and be patient.” 
  • Set boundaries.  Your loved ones may have their own opinions, so be clear with people how they can support you.  By having clarity around your own needs, you’ll be able to communicate how they can help

English novelist George Orwell said, “If you want to keep a secret, you must also hide it from yourself.”  By choosing to keep things private you are making a decision not to face what is ahead of you.  Through opening up, you’ll be able to process your own emotions more easily, while also relying on the support of your trusted circle.  You owe it to yourself, and those who love you, to let people in and let go of your secrets.

SOURCES

Psychology Today

Mental Health Net

Huff Post

Psychology Today

Scientific American

Mental Health in America

You Can Live Joyfully

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As a caregiver, it’s especially important to find joy in your daily life.  If you make the deliberate decision to seek joy you can succeed through any struggle and pain that might come your way.

Inspired by the best-selling book Living With Joy, here’s an activity you can complete so that YOU CAN LIVE JOYFULLY.

  1. Think of seven things you love to do, that feel joyful when you do them and have NOT done in the last several months. 
  2. As you think of each of these things, reflect on what stops you from doing each one. 
  3. Take two or three items that hold the most joy for you, and think of one step you can take toward each to bring it into your life.
  4. Mark your calendar with a date and time that you will bring each of these joyful activities into your life.

You deserve to feel joy, regardless of your circumstances.  Take the steps to make it happen!

ABS Is Supporting Breakthrough Anorexia Nervosa Research

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The American Brain Society is proud to announce its support for two cutting-edge research projects for anorexia nervosa.  Anorexia nervosa has the highest mortality rate of any psychiatric disorder, with one in every 200 American women suffering from the disease at some point during her life.

Our participation in these projects for anorexia nervosa showcases our unwavering commitment and support for the Scientific Research Community who are working tirelessly toward finding treatment and cures for this brain disorder and many others.

Both research projects have been vetted to ensure we select innovative initiatives with the most promising outcomes, and are championed by renowned doctors who are leaders in their respective fields.

About The Research & The Scientists Leading The Way

Project One: Taste Preferences, Brain Reward Circuitry Activation, And The Neurobehavioral Effects Of Weight Restoration In Anorexia Nervosa

Lead Scientist:  Angela Guarda, MD

Scientific Goals & Description

Although its cause is unknown, one factor believed to contribute to the disorder’s stubborn perseverance is the dysregulation of brain reward systems activated by palatable, calorie-dense foods.  The purpose of this study is geared at identifying brain reward-circuitry mechanisms involved in anorexia nervosa and to direct the development of future, personalized, treatment options and medical therapies.  

Current treatment focuses on weight restoration and the normalization of food intake, essential components of recovery and remission.  Through this project, Dr. Guarda and her team of eating disorder experts seek to understand brain changes that maintain anorectic thinking and behavior patterns, with the ultimate goal of improving existing treatments for severe anorexia nervosa.

Scientific Process

Using functional magnetic imaging (fMRI) before and after hospital-based treatment for anorexia nervosa, the researchers will scan brain reward circuitry and look for any neural correlation with this disorder.  Dr. Guarda and her team are very interested in shifts in taste preference and changes in the activation of brain reward circuits in the acutely ill versus the weight restored states of anorexia nervosa.

Project Extension

Following this pilot project, the team will seem funding to extend the research to study additional considerations such as the rehabilitation comparison of healthy-weight matched control participants to those with anorexia nervosa.

About The Lead Scientist, Angela Guarda, MD

There is no doctor more experienced and knowledgeable in the field of eating disorders than Dr. Angela Guarda. She has over 20 years of experience as the Director of the Eating Disorders Program at Johns Hopkins Hospital and is an expert in the intensive treatment of adult anorexia nervosa with high severity and chronicity.  The recipient of grant funding and countless awards, including America’s Top Doctors, and an active member of the psychiatric and research community, it is her expertise and commitment to her patients that helps people get better.

“Dr. Guarda is easily one of the top clinicians I have ever dealt with, in any field.  I was a patient on the Johns Hopkins Eating Disorders unit roughly 7 1/2 years ago (hospitalized for anorexia)…The program Dr. Guarda runs is considered to be one of the best in the nation – it is not easy but patients get well.  Alongside the toughness, though, is an extremely compassionate human being who deeply cares about her patient’s outcomes,” says a former patient of Dr. Guarda.

Renowned for her forefront thinking, Dr. Guarda’s clinical research interests include improving behavioral interventions and weight restoration outcomes for severe anorexia nervosa.  Her research lab is focused on things such as:

  • Alterations in attention to food stimuli
  • Decision-making around food choice
  • Neurobiological alterations that contribute to sustaining a dietary restriction
  • Other weight control behaviors in persons with anorexia nervosa. 

She also closely collaborates with her colleagues on research including meal-based studies examining disturbances in neuroendocrine hunger and satiety signaling that may sustain disordered eating behavior, and in the study of animal models of anorexia nervosa. 

The video below highlights Dr. Guarda and her extraordinary work as the Director of the Eating Disorders Program at Johns Hopkins Hospital.

Project Two: Role of Oxidative Stress in Patients with Anorexia Nervosa

LEAD SCIENTIST:  Timothy H. Moran, Ph.D.

Scientific Goal & Description

Acutely ill patients with anorexia nervosa have been shown to have increased oxidative stress, an imbalance between antioxidants and free-radicals compared to healthy controls.  Similarly, a low ratio of antioxidants to free radicals has been observed in several disease states including obsessive-compulsive disorder and drug addiction, other psychiatric disorders characterized by compulsive behaviors and high rates of relapse. 

Relapse rates remain significant, so the goal of this project is to examine oxidative stress as a potential biological mechanism contributing to the relapse in anorexia nervosa patients.

Scientific Process

This research project will address the relationship of the oxidative state of patients with anorexia nervosa in various stages of the disorder such as improvement, weight regain, rehabilitation, relapse and more.  Researchers will test blood from patients at admission and at discharge from the Johns Hopkins Eating Disorder Program, a highly successful inpatient weight restoration program for patients with anorexia nervosa directed by Dr. Angela Guarda.  These samples will be processed for markers of oxidative stress, and following following weight restoration, patients will be administered an antioxidant, N-acetylcysteine, to determine if this provides therapeutic relief and prevent relapse.

Project Funding 

Further funding will provide more equipment and supplies needed for Dr. Moran and his team, and support a pilot study to determine whether the administration of the antioxidant and nutritional supplement N-acetylcysteine curbs compulsive behaviors including restrictive eating and exercise following weight restoration and impacts relapse risk.

About the Lead Scientist, Timothy H. Moran, PH.D.

Like his colleague, Dr. Guarda, Timothy H. Moran, Ph.D., is at the forefront of his field.  He leads the way in research for eating disorders, obesity, and weight disorders.

Dr. Moran is the Paul R. McHugh Professor of Motivated Behaviors and the Executive Vice-Chair for the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine. 

He is also Director of Behavioral and Biological Research in the Johns Hopkins Global Center for Obesity Prevention at the Bloomberg School of Public Health, where he has a joint appointment as Professor of International Health.

For nearly 40 years, Dr. Moran has dedicated himself to breakthrough research and relentless commitment to his patients.  His research projects have resulted in over 325 original data articles, reviews, and book chapters.  Dr. Moran is also a Council member of the Obesity Society, past president of the Society for the Study of Ingestive Behavior, and chair of the NIH Integrative Physiology of Obesity and Diabetes Study Section.

A sought-after speaker and renowned clinician, his research interests are in brain/behavior relationships as they apply to the control of food intake and body weight and is focused on elements such as:

  • The causes and consequences of obesity and eating disorders
  • Brain/gut peptides as feedback controls of meal size and how these interact with hypothalamic and reward systems involved in overall energy balance
  • The effects of exercise on food intake and hypothalamic signaling
  • How gestational and early developmental factors can bias metabolic programming through epigenetic mechanisms to contribute to obesity and type II diabetes

His lab conducts experiments at multiple levels using cell and rodent models and normal and patient populations. He collaborates widely on human studies involving obesity and eating disorders and on studies modeling aspects of the food environment and their effects on obesity.

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